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Left main coronary artery disease (CAD) and diabetes pose significant challenges in cardiovascular care, often leading to adverse outcomes. Preliminary evidence from trials focusing on patients with multivessel disease has hinted at diabetes as a potential modifier of treatment outcomes. Original article: Gaba P et al. Circulation.
Diabetes mellitus (DM) has been shown to increase the rate of aortic stenosis (AS) progression. However, the impact of impaired plasma glucose on valvular calcification remains poorly understood. Using ex vivo.
About a fifth of all ischemic strokes are attributed to embolization of ruptured atherosclerotic plaque from carotid arterial stenosis. But it has been difficult to predict which person with asymptomatic carotid artery stenosis is likely to progress to symptomatic carotid disease and stroke. J Am Coll Cardiol. doi: 10.1016/j.jacc.2024.03.389.
Patients were categorized by diabetes status. Kaplan-Meier event rates, Cox model hazard ratios, and interactions were assessed.RESULTS:Among 4393 patients, 1104 (25.1%) had diabetes. Kaplan-Meier event rates, Cox model hazard ratios, and interactions were assessed.RESULTS:Among 4393 patients, 1104 (25.1%) had diabetes.
This comprehensive literature review focuses on acute stroke related to intracranial atherosclerotic stenosis (ICAS), with an emphasis on ICAS-large vessel occlusion. Various risk factors, including hypertension, diabetes, hyperlipidemia, smoking, and advanced age lead to ICAS, which in turn results in stroke through different mechanisms.
reported results from a clinical study of revolutionary earbuds that use a new technology - In-ear Infrasonic Hemodynography to Detects Aortic Stenosis Murmur Before and After Transcatheter Aortic Valve Replacement (TAVR). We propose a new method of assessing aortic stenosis through IH to detect its characteristic systolic ejection murmur."
Reducing the high risk of recurrent stroke in patients with symptomatic intracranial atherosclerotic stenosis (sICAS) has proven to be challenging, but aggressive medical management, with intensive risk factor control and antithrombotic therapy, has been shown to be beneficial. Stroke, Volume 55, Issue 2 , Page 335-343, February 1, 2024.
For this study, acute symptomatic was defined as hemispheric ischemic stroke or retinal ischemia ipsilateral to the carotid stenosis, with symptom onset within 24 hours of admission. After adjusting for confounders, only LDL-C levels were associated with the acute symptomatic status of carotid stenosis. were asymptomatic and 40.2%
Introduction:Medical treatment of internal carotid artery stenosis consists of treatment of underlying conditions such as hypertension, dyslipidemia, and diabetes mellitus, as well as antiplatelet therapy. This may lead the way to new drug therapies for carotid artery stenosis.
Duplex US revealed 80‐99% stenosis of both right and left proximal internal carotid arteries. The constellation of findings was most suggestive of bilateral limb‐shaking TIA secondary to bilateral carotid stenosis. He was started on secondary stroke prevention and referred to vascular surgery for evaluation of revascularization.
Aortic valve calcification (AVC) is an underlying pathophysiological mechanism in aortic stenosis, which shares many risk factors with diabetes. However, the association between dysglycemia and early stages of.
The real-world patient population analysis, which is the largest dataset of Prevail patients with nearly 1,800 patients, compared the Prevail DCB to other DCBs in a complex patient population, including bifurcations, acute coronary syndrome and diabetes. Prevail DCB is limited to investigational use in the U.S.
Objective To investigate the impact of prior coronary artery bypass grafting (CABG) and coronary lesion complexity on transcatheter aortic valve replacement (TAVR) outcomes for aortic stenosis. Conclusion Prior CABG may positively affect mid-term TAVR outcomes for aortic stenosis compared with no CAD when adjusted for other comorbidities.
However, the long-term outcomes in patient with an intermediate stenosis received FFR have not yet been investigated comprehensively.Methods:We retrospective included 558 patients underwent both coronary artery angiography (CAG) and FFR. The nomogram consists of age, smoking, hypertension, diabetes mellitus (DM), hyperuricemia, and FFR≤0.8
Bar plots: in red, patients with low flow-low gradient (LF-LG) aortic stenosis; in blue, patients with normal flow-high gradient (HG) aortic stenosis; in black: controls. Aim Cardiac remodelling plays a major role in the prognosis of patients with aortic stenosis (AS) and could impact the benefits of aortic valve replacement.
Patient 2 A man in his 50s with history of CAD and prior PCI, diabetes, presented with acute constant chest pain for the past few hours. His disease included 70% prox LAD, 80% distal LAD, 10% in-stent stenosis in the distal LCX, 70% OM1, 70% OM2, and 60% prox RCA. He was discharged home. Described as a dull ache, 6/10 in severity.
The CAD Staging System is a noninvasive imaging-based investigational software device that analyzes important and actionable features of coronary atherosclerosis, stenosis and ischemia. Food and Drug Administration ( FDA ) for its Coronary Artery Disease ( CAD ) Staging System.
Background:Vertebrobasilar artery stenosis (VBAS) can cause posterior circulation strokes (PCS). Hypertension (HTN, 85.4%) and diabetes (DM, 18.9%) were prevalent. Circulation, Volume 150, Issue Suppl_1 , Page A4135852-A4135852, November 12, 2024. Mean age was 69.45 years, with 64.1% Demographics: 69.8% Hispanic, and 5.3% other races.
In this study, we evaluated the relationship between flossing and ICAS, defined as 50% stenosis. The association remained significant after adjustment for age, race, gender, hypertension, diabetes, smoking status, education level and regular dental care use (Adjusted OR 0.61 The log WMH volume was higher (9.50.85
Cholesterol may cause or exacerbate some types of valvular heart disease, so drug companies are testing statins and PSK9 inhibitors (which lower cholesterol even more than statins) against aortic stenosis.
According to the analysis of receiver operating characteristic (ROC) curve, AUC, DCA and sensitivity, all seven machine learning models perform well and random forest (RF) machine model was found to perform best (AUC-ROC=0.9008, Accuracy: 0.9008, Precision: 0.6905; Recall: 0.7532, F1: 0.7205).
24: Joint American College of Cardiology/Journal of the American College of Cardiology Late-Breaking Clinical Trials (Session 402) Saturday, April 6 9:30 – 10:30 a.m. 12:15 p.m.
A 40-something with severe diabetes on dialysis and with known coronary disease presented with acute crushing chest pain. 2 years prior he had an angiogram which showed 90% proximal stenosis of the circumflex. Left main: no obvious stenosis. D1: severe (90%) de-novo stenosis in the mid to distal segment.
FAI was still associated with global CFR after adjusting for traditional risk factors (age, hypertension, diabetes, hyperlipidemia, and smoking). Altogether, FAI can help reveal microcirculatory damage in patients who do not exhibit epicardial artery stenosis.
Results:Among the 36,403 participants (14,676 males, 40.3%), the prevalence of stroke, heart disease, hypertension, diabetes mellitus, and dyslipidemia was 7.4%, 6.4%, 55.7%, 17.3%, and 40.2% 2021-KY-1289-001).Results:Among respectively.
Semaglutide reduces late sodium current (I Na ) and diastolic calcium (Ca) sparks in human cardiomyocytes from aortic stenosis (AS) and end-stage heart failure with reduced ejection fraction (HFrEF) patients, thereby increasing Ca transients. Improved Ca storage may underly the enhanced contractility of human cardiomyocytes upon semaglutide.
However, CTA head and neck 4 days later demonstrated 90 percent stenosis of the mid left V2 at the C3‐4 level and a 75‐90 percent stenosis of the left mid V2 segment at the C5‐6 level (hard and soft plaque in these areas). He also had moderate stenosis of the right V4 segment.
Background Increase in left ventricular filling pressure (FP) and diastolic dysfunction are established consequences of progressive aortic stenosis (AS). years and were more likely to be males (62%), diabetic (41% vs 35%, p=0.046), and have a higher prevalence of atrial fibrillation (Afib) (53% vs 39%, p<0.001).
to 13.01; 4.06), diabetes mellitus (123.3; to 6.85; 4.54), aortic stenosis (18.7; Higher-predicted risk, compared with lower-predicted risk, was associated with incident chronic kidney disease (cumulative incidence per 1000 persons at 10 years 245.2; HR 6.85, 95% CI 6.70 to 7.00; median time to event 5.44 years), heart failure (124.7;
The sample included patients who presented with stroke due to severe stenosis and underwent elective stenting, and those who presented with large vessel occlusion (LVO) with underlying ICAD who underwent rescue stenting following thrombectomy. vs 7.9%), diabetes (33.6% vs 4.6%), obesity (26.4%
IntroductionEndoscopic endonasal approach(EEA) techniques have been increasingly utilized and have been associated with development of cerebrospinal fluid(CSF) leak, meningitis, diabetes insipidus post‐operatively. MRA head demonstrated multifocal arterial stenosis. Cerebral vasospasm following EEA has rarely been described.
At 5‐months follow‐up, patient’s exam was non‐focal with NIHSS 0 and repeat DSA showed no evidence of stent occlusion and patent M1 segment.ConclusionXience Skypoint EES can be successful in treating symptomatic MCA stenosis refractory to maximal medical therapy with good long term results.
LDL cholesterol, when measured in the context of diabetes, metabolic syndrome or insulin resistance, is not an accurate reflection of the number of apoB particles in circulation. “How can you tell the difference between aortic stenosis and mitral regurgitation at the bedside?” I tell all of them that they are wrong.
A 56 year old male with a history of diabetes, dyslipidemia, hypertension, and coronary artery disease presented to the emergency department with sudden onset weakness, fatigue, lethargy, and confusion. The red arrow points to a 90% stenosis in the proximal segment of the LAD. RAO Caudal view: This is the RAO Caudal view.
Held in London on 6 th October 2023, this popular meeting mixed presentations from experts in cardiology, diabetes and renal medicine with the opportunity for delegates to network, share and discuss their knowledge and expertise. Dr Mohammad Wasef and Dr Sarah Birkhoelzer report its highlights.
Reasons for not prescibing or discontinuing were: CKD 6, severe aortic stenosis 5, asthma 3, symptomatic bradycardia 5, hypotension 3, type1 diabetes 2, syncope 1, Raynauds 1, patient choice 8 and 6 patients died before all appropriate medications could be initiated. In 10 cases no clinical reason could be identified.It
The real-world patient population analysis, which is the largest dataset of Prevail patients with nearly 1,800 patients, compared the Prevail DCB to other DCBs in a complex patient population, including bifurcations, acute coronary syndrome and diabetes. Prevail DCB is limited to investigational use in the U.S.
His history included known heart failure with prior EF 18%, insulin dependent diabetes, and polysubstance abuse. He was taken rapidly to the cath lab and here are some representative images before and after intervention: Acute proximal LAD culprit with TIMI 0 flow, 100% stenosis, thrombotic occlusion, requiring thrombectomy and PCI.
Case Description:A 59-year-old male with history of hypertension, diabetes, Hashimoto’s thyroiditis presented with new, progressive shortness of breath. Notably, the LAD had multiple aneurysmal segments and areas of eccentric stenosis upto 90%.Multislice No murmur or extra heart sound were heard, and the lung sounds were normal.
We present a complex case of NSTEMI with multi-vessel coronary artery disease treated with PCI via the Carlino technique.Case Description:A 60-year-old female with a history of hypertension, diabetes mellitus, and ischemic heart disease presented with severe chest pain that radiated to the neck and was associated with nausea and vomiting.
SMART 4 ( NCT04722250 ) studied patients with severe aortic stenosis and a small aortic annulus who underwent transcatheter aortic valve replacement (TAVR). STEP-HFpEF DM 5 ( NCT04916470 ) explored the effects of semaglutide in obesity-related HF with preserved ejection fraction (HFpEF) and type 2 diabetes. vs. 6.2%) and stroke (2.9%
1.25, p<0.001), diabetes (OR 2.52, 95%CI 1.41-4.53, 0.90, p=0.030) was inversely associated with AD group.Conclusions:Although the previous study exhibited that AD was predominantly associated with intracranial stenosis in atherothrombotic brain infarction, AD was also crucially related to ACL in CS in the present study.
Moreover, the sdLDL-C/LDL-C ratio was associated with a higher odds ratio of incident carotid plaques in participants without diabetes (Pfor interaction=0.014).CONCLUSIONS:Higher The upper tertile of sdLDL-C (versus lower tertile) was associated with the multivariate-adjusted odds ratio of 2.48 (95% CI, 1.00–6.15;P=0.049;Pfor
Written by Magnus Nossen The patient in today's case is a male in his 70s with hypertension and type II diabetes mellitus. Below is a still image with the red arrow indicating the subtotal LMCA stenosis. His wife contacted the ambulance service after the patient experienced an episode of loss of consciousness.
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